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Listen: Plasma and Immunity

Wells: Is there any downside to giving people plasma, even if you don’t know if it’s going to be specifically helpful to them?

Hamblin: There theoretically shouldn’t be, but there could be and that is the reason that you don’t just authorize these things, that you have an FDA to make sure that something is safe and effective.

Kola: It seems like people have antibodies within three months of them having COVID-19. And I definitely had antibodies back in May when I was given an antibody test, but given the news out of Hong Kong, it looks like those antibodies may wane over time? When I imagine the plasma, am I imagining blood that has actual antibodies in it, or does it have the memory of how to make antibodies? What’s actually in the plasma?

Hamblin: You’re just getting the antibodies themselves. The act of producing them will involve the white blood cells that should be taken out of plasma—

Wells: They’re the things that make the antibodies … and that have a memory of how to make them?

Hamblin: Right. When you transmit plasma, you’re not teaching someone to make antibodies. That’s what happens by exposing them to the virus. That’s vaccination. Transmitting plasma grants what’s called “passive immunization” where you temporarily have these antibodies until your blood clears them out. Then you’d theoretically have to get another transfusion.

Kola: So there would be the possibility that, having had COVID-19 in March, and maybe being called upon to donate plasma in October, my blood might not have the antibodies anymore that it had in May?

Hamblin: Yeah, that remains possible.

Kola: Wow.

Wells: Is that upsetting?

Kola: I think it’s like much to do with COVID-19, just one of the confusing complexities. I know that I had the antibodies at one point. I can’t know for sure that I have them now without another antibody test. Being someone who had it relatively early, my experience of the virus is myself and everyone around me learning about it almost in real time.

Hamblin: Well, if it helps reassure … I guess Katherine can explain the immunology here because we had a whole episode on this … but there is more to your body’s memory than just the presence of antibodies themselves. There are immune messaging pathways such that even if you lost your antibodies, it’s possible that your body might be able to quickly make new ones and call them back and have other ways of fighting off this virus so that, if you are reinfected, it is not so bad, even if you don’t actively have the antibodies.

Kola: Can you explain how people like me who had COVID-19 and are hopeful about immunity should interpret the information from Hong Kong, because that was obviously, on the face of it, quite scary for people who’ve had an experience that they wouldn’t wish to go through again.

Wells: Can you explain the Hong Kong news, Jim? Doctors in Hong Kong reported the first case of confirmed reinfection, which is obviously terrifying, but what does it really mean?

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